Finding the Most Effective Home Remedies for IBS: Focusing on the Gut Microbiome

April 17, 2018

Irritable bowel syndrome (IBS) is one of the most challenging gastrointestinal disorders to effectively manage and treat because there is no single, clear cause that applies to all patients. Often, it is a “diagnosis of last resort,” when physicians simply cannot find another cause to explain the patient’s symptoms. These symptoms are often wide-ranging, may be opposing, and can include diarrhea, constipation, abdominal pain, bloating, and flatulence.

While there are a number of prescription IBS medications on the market, patient experiences and drug efficacy are mixed. As a result, many patients look toward home remedies to find greater relief than prescription options can provide. The targets of home remedies can vary considerably depending on patient needs, but IBS home remedies with universal appeal focus on supporting the health of the gut microbiome, which can play a role in any and all symptoms of IBS. Researchers who have studied the efficacy and mechanisms of home remedies have found that changes in both diet and exercise habits can improve the gut microbiome in a way that supports positive outcomes for IBS patients.

Exercise as a Home Remedy for IBS

The earliest evidence that exercise can support the gut microbiome came from a study by a group of researchers in Japan, who reported that running exercise could alter the bacterial composition of the gut microbiome in rats. More specifically, these rats had higher gut concentrations of n-butyrate than their sedentary counterparts. The relevance of these findings for patients with IBS was clarified in a 2015 study, in which researchers compared the microbiota of IBS patients to those of healthy controls. Based on over 20 million 16S rRNA samples from patient fecal samples, the researchers found that patients with IBS had significantly lower levels of microbial diversity—and, most notably, they had lower levels of the bacterial genera that produce butyrate. This disruption of the microbiome may be responsible for a range of IBS symptoms and dictate symptom severity. Although no human studies have yet associated butyrate production with exercise, the studies in mice help to make a strong case for the potential of exercise to normalize butyrate concentrations in patients with IBS.

More recently, researchers at Rutgers University also found that exercise altered the gut microbiome of mice—regardless of whether they were on a standard or a high-fat diet—and that the changes in microbial composition modulated both inflammatory markers and gut integrity in the exercising mice. Because inflammation and intestinal permeability both have an impact on symptoms in IBS patients, this study suggests that using exercise to improve the gut microbiome may be beneficial for patients through a variety of mechanisms.

There is also preliminary evidence from clinical studies supporting the possible benefits of exercise for IBS patients, including a landmark randomized clinical trial conducted by a group of Swedish researchers. They randomly divided a group of 102 IBS patients into a sedentary control group and a treatment group who performed 20 to 60 minutes of moderate exercise, 3 times a week for 12 weeks. Their symptoms were measured using an IBS Severity Scoring System, and the results showed that there was a statistically significant reduction in IBS symptoms for those who exercised, as compared to those who did not. Although the authors did not specifically probe the molecular mechanisms through which these benefits were conferred, the results showed that even a small amount of exercise could truly make a difference for patients with IBS.

Gut Microbiome-Supporting Dietary Modifications for IBS Management

While exercise appears to hold significant promise for IBS management, dietary interventions may also offer meaningful symptom relief. Although such strategies have traditionally focused on elimination diets that seek to identify individual “trigger” foods, researchers are increasingly investigating ways to address the underlying, pathophysiological causes of IBS. Many of these efforts have focused specifically on improving the health of the gut microbiome.

The simplest studies have demonstrated the possible efficacy of both probiotic supplements and high-probiotic foods, like yogurt. Some studies suggest that targeted therapies focused on addressing specific microbial deficiencies may make a particular difference for IBS patients. For instance, one study of 274 patients with constipation-predominant IBS (IBS-C) found that participants who ate a probiotic yogurt containing Bifidobacterium animalis had lower abdominal discomfort scores and a significantly higher number of bowel movements per week than participants in the control group, who ate a placebo. There have also been multiple studies suggesting that probiotic supplements containing B. infantis may be particularly useful for patients with IBS, while studies on other probiotics have been less promising. Based on the studies suggesting that the gut microbiota of patients with IBS are different from those of the general population, it makes sense to focus on key, evidence-based probiotic options when choosing dietary probiotic-based home remedies for IBS.

Given the associations between IBS and butyrate, butyric acid supplements are also emerging as a potential dietary therapy. As home remedies for IBS, butyric acid supplements are particularly appealing to clinicians and researchers because of their biochemical support—rather than the mixed, anecdotal evidence that underpins many other herbal supplements that are purported to address IBS symptoms. Additionally, there a number of clinical studies indicating the efficacy of butyric acid supplements for IBS patients. As of a 2017 review, two clinical studies had been conducted, and both yielded positive results:

In a 2012 study, researchers compared a control group of 29 patients receiving a standard treatment of trimebutine and mebeverine with a similarly-sized treatment group of patients who took an additional 300 mg of sodium butyrate each day. After six weeks, the researchers noted a statistically significant improvement in IBS symptoms among the treatment group, and these patients also reported higher scores on a subjective Quality of Life assessment.

A similar study in the same year served to verify these results. A group of 66 patients who had a multi-year history of IBS were divided between a control group (32 patients) and a treatment group (34 patients) who took 300 mg of sodium butyrate per day. After four weeks, the researchers noted a statistically significant decrease in abdominal pain, and after twelve weeks, there was a statistically significant decrease in all of the symptoms they had studied: abdominal pain, flatulence, bowel movement, mucus in stool, and quality of life interference.

Together, these studies provide strong preliminary evidence of the efficacy of sodium butyrate for patients with IBS, at least when used in combination with conventional therapy. Future studies may probe the effects of the different forms of sodium butyrate that are available. In addition, studies may be conducted on larger patient groups or those who have not yet been treated for IBS symptoms. Going forward, it is also important to note that sodium butyrate is not the only possible solution for IBS patients. There are ongoing studies on a variety of pharmacological, dietary, and lifestyle interventions that may offer relief.

Implications for Clinicians and Patients

As far as home remedies for IBS go, there are, regrettably, no simple solutions. Still, there is rigorous research evidence to support the idea that targeting the gut microbiome—either with exercise, dietary modifications, or nutritional supplements—is an effective solution for many patients, regardless of which type of IBS they have. These simple home remedies have the potential to reduce symptoms and improve quality of life in patients with IBS—the two key long-term goals of IBS management.

Foundation Medical Review explores the latest research to help researchers, clinicians, and patients understand the biochemistry behind IBS treatment methods and the clinical evidence that supports it. Join our mailing list to receive regular newsletters with insight and updates.